Nagpur: Cancer treatment, which includes chemotherapy, radiotherapy and surgery, has been continuously evolving. Patients no longer dread it as much as they used to about 2-3 decades back, due to better availability of newer and targeted drugs, radiation and even surgical excision of the tumours. Also there has been a shift in incidence of certain cancers over others.

As far as surgical treatment is concerned Dr Anil D’Cruz, director of Tata Memorial Hospital (TMH), country’s premier cancer hospital told TOI that a study conducted by TMH on oral cancer patients from 2004 to 2014 on 596 patients had shown that conducting a elective neck dissection in patients gave better survival results than therapeutic neck dissection in early oral cancers. “Out of every eight patients operated one patient’s life could be saved. Also it was possible to prevent recurrence of tumour in one patient out of every four patients,” he said. There were 81 recurrences and 50 deaths in the elective-surgery group and 146 recurrences and 79 deaths in the therapeutic-surgery group. Dr Neeti Kapre, daughter of ENT surgeon Dr Madan Kapre was also a part of the study and a coauthor of the paper.

Elective neck dissection improved overall survival by 12.5% and reduced risk of death by 36% when compared with a wait-and-watch policy for therapeutic neck dissection in early, node-negative, squamose cell carcinoma of the oral cavity. Dr D’Cruz, said elective neck dissection also improved disease-free survival by 23.6% and reduced the risk of recurrence by 55%.

The study was published in the New England Journal of Medicine. India also presented this study in the plenary session of the Amercian Society of Clinical Oncology held in May this year.

Talking on the need for more such cancer institutes in country Dr D’Cruz said that the department of atomic energy was setting two cancer hospitals of TMS standard at Vishakhapatnam and Chandigarh and will be called as Homi Bhabha cancer Hospitals. The Union health ministry is also setting up National cancer Institutes at Jhajjar in Haryana with a budget as high as Rs2,500 crore. “Every year about 11-12 lakh new cancer patients are added in the country. Hence we do need many more national level centres,” he said.

In radiotherapy recent developments like Intensity Modulated Radiotherapy which has very little side effects allows the treating doctor to give higher doses to the patient without problems. In chemotherapy it is now possible to intensify the treatment of a patient due to newer drugs. Better molecular testing and targeted treatment has changed cancer treatment for the better. For example in breast cancer it is now possible to send Herneu2 a receptor that sits on particular cells. In lymphomas it is possible to target drug which sits on the EGFR receptor only resulting in better results. In lung cancer there are ten targeted therapies.